NJ now requires large employer health plans to provide abortion coverage

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As part of an effort to expand access to reproductive health care in New Jersey, the state is now requiring large employers to provide coverage for abortion services.

The mandate, which has been in place as of Jan. 1 in the individual and small employer health insurance markets, will now be in effect for the fully insured large employer health insurance market upon issuance or renewal, the state’s Department of Banking and Insurance announced in a Sept. 18 press release. 

Following the January 2022 enactment of the Freedom of Reproductive Choice Act, the department was mandated to study whether health insurance in the Garden State should cover reproductive health.

In a report released in November 2022, the department found a need for regulatory action to require coverage for abortion services without exceptions under health benefit plans regulated by the department.

While most New Jersey health plans offered abortion coverage, some limited it to cases involving incest or rape, or when a pregnancy threatened the mother’s life, according to the study.

It also determined mandating abortion coverage “will not increase premiums in any material way,” estimating the impact to be between 0% and 0.1%. and that those increases could be mitigated by savings from a reduction in pregnancy care, including prenatal visits, delivery and postnatal visits. The study also noted such a measure “would be consistent with actions taken in other states.”

After that, the department began formal rulemaking processes to move forward with the requirement.

In a Sept. 18 statement, acting Commissioner Justin Zimmerman said, “Insurance coverage for reproductive health services is essential to expanding access to comprehensive care. Today’s enactment reduces barriers to these critical health services, ensuring that health insurance carriers regulated by the department provide abortion coverage without exceptions.”

Within New Jersey, the state has authority over the health insurance markets for individuals, small employers and large employers, which includes plans offered on and off the marketplace and through Get Covered New Jersey, the state’s official health insurance marketplace.

In a statement, Gov. Phil Murphy said, “New Jersey remains a leader in safeguarding reproductive rights and health care services. Implementation of this requirement across department-regulated plans will provide access to abortion services without exceptions limiting coverage—reaffirming a women’s ability to make medical decisions about her reproductive health. This rulemaking is another step forward in ensuring residents can access the reproductive care they both need and deserve.”

In addition to abortion rights, the Freedom of Reproductive Choice Act codified the right to access contraception, the right to terminate a pregnancy and the right to carry a pregnancy to term.